An effective strategy for neonatal hyperbilirubinemia

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Hyperbilirubinemia remains a major cause of prolonged hospital stays and readmissions for newborns. Careful initial screening of all infants and targeted follow-up for higher-risk infants will identify most infants at risk of bilirubin toxicity in a timely fashion. The exceptions are occasional infants with G6PD and other genetic abnormalities that can cause acute hemolysis in newborns. However, initial detection and follow-up systems are seldom ideal and infants continue to develop bilirubin toxicity.

Kaplan et al report an efficient management approach that combined pre-discharge screening with culturally-based community awareness to detect and effectively treat hyperbilirubinemia. However, 42% of the infants that required re-hospitalization were not identified as being at risk by pre-discharge screening. The study points out the need for effective follow-up for successful detection of some infants with hyperbilirubinemia.